What criteria should I use to determine when to refer a patient with clubfoot to a specialist?

While the provided guidelines do not explicitly mention "clubfoot," criteria for referring a patient with limb deformities and contractures to a specialist, such as an orthopaedic surgeon, are outlined ³.

You should consider an assessment by an orthopaedic surgeon if the patient presents with muscle shortening, contractures, or bony deformities that limit limb function, for example, affecting walking or getting dressed ³. This referral is also appropriate if contractures of the shoulder, elbow, wrist, or hand cause difficulty with skin hygiene, or if the cosmetic appearance of the upper limb causes significant concern for the child or young person ³.

Additionally, for children with abnormal limb posture that has no apparent musculoskeletal cause, a neurological assessment should be considered ¹. Children with new-onset gait abnormality should be referred immediately to acute paediatric services ¹.